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耳内镜在小儿腺样体肥大诊治中的应用

摘要

Objective To explore the application of auriscopic nose- nasopharyngeal examina tion in the diagnosis and treatment of adenoid hypertrophy in children. Methods Auriscopic nose-na sopharyngeal examination was performed in 412 children with the symptoms of upper airway obstruction to explore the relationship between the degree of adenoid enlargement and upper airway obstruction. Results The procedure was successfully performed in 395 of 412 children. Of the 395 children, 358 had adenoid hypertrophy, 14 had choanal polyp, 16 has allergic rhinitis, and the remaining 7 had chronic rhinitis. Accord ing to the degree of rear nasal passage blockage, in 358 children with adenoid hypertrophy, 43 (12%) was grade Ⅰ, 97 (27%) was Ⅱ, 103 (28.8%) was Ⅲ, and 115 (32.2%) was Ⅳ. Conclusions Auriscopic nose nasopharyngeal examination is an ideal procedure for nasopharyngeal adenoid hypertrophy in children. It is directly visual, accurate, and safe. Grade Ⅳ adenoids is the main etiology of upper airway obstruction in children, which is the indication of surgical treatment.%目的 探讨耳内镜下鼻-鼻咽检查在小儿腺样体肥大诊治中的应用.方法 对412例具有上气道阻塞症状的患儿采用耳内镜进行鼻-鼻咽检查,分析腺样体增大程度与上气道阻塞的关系及其可行性.结果 412例中395例完成检查(17例因患儿哭闹,不能配合检查). 395例单纯诊断性检查:腺样体肥大358例,后鼻孔息肉14例,过敏性鼻炎16例,慢性鼻炎7例.358例腺样体肥大病例中,根据腺样体阻塞后鼻孔的情况分为:Ⅰ级43例(12%),Ⅱ级97例(27%),Ⅲ级103例(28.8%),Ⅳ级115例(32.2%).结论耳内镜鼻-鼻咽检查适合于小儿腺样体肥大检查,该法直观、准确、安全,是判断小儿腺样体肥大有效、直观的检查方法.Ⅳ级腺样体是小儿上气道阻塞的主要病因,是手术治疗的适应证.

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